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COMPLIANCE INFO_2022
Environmental Health - Public
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1600 - Food Program
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PR0541418
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COMPLIANCE INFO_2022
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Last modified
10/18/2022 1:41:55 PM
Creation date
10/18/2022 1:40:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0541418
PE
1608
FACILITY_ID
FA0023734
FACILITY_NAME
TERRA COFFEE ROASTERS
STREET_NUMBER
3044
STREET_NAME
HORSETAIL
STREET_TYPE
DR
City
STOCKTON
Zip
95212
CURRENT_STATUS
01
SITE_LOCATION
3044 HORSETAIL DR
P_LOCATION
01
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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SHAWNA N �J O a i� I I I Environmental Health Department <br />—HCOUNIT,JYU <br />7. Delivery Limitation: Initial if you agree to abide by the following: U <br />I understand that I may accept orders and payments via the internet, mail or phone. However, all "Class K and <br />"Class B" CFO products must be delivered directly (in person) to the customer. The CFO products may not be <br />delivered via the United States Postal Service, UPS, FedEx, or using any other indirect delivery method as <br />deliveries are regulated by, and subject to, CDPH registration and state and federal requirements. <br />8. Owner's Statement: <br />I, La ra &WrUq , agree to grant access to the local health department to <br />conduct an inspection of my cottage food operation (mark one) <br />"Class A": In the event of a consumer ❑ "Class B": For regular annual facility inspections <br />complaint or reported food -borne illness and in the event of a consumer complaint or <br />food -borne illness <br />I, Lauret- (rar%i G[ , agree to notify the San Joaquin County Environmental <br />Health Department prior to modifying my food list, type of operation, and/or method of selling, distributing, or <br />otherwise providing my CFO products to the consumer or retailers, regardless of whether the product is sold, <br />consigped, or given away. <br />I/2gI2Z <br />Date <br />EHD 18-298/27/22 2 CFO REGIPERMITTING RENEWAL FORM <br />
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